Show notes at pharmacyjoe.com/episode159.
In this episode, I’ll discuss the updated sepsis guidelines from the 2016 Surviving Sepsis Campaign.
Critical Care and Hospital Pharmacy Resources for Hospital Pharmacists, PGY-1 Pharmacy Residents, PharmD students, and Preceptors
Show notes at pharmacyjoe.com/episode159.
In this episode, I’ll discuss the updated sepsis guidelines from the 2016 Surviving Sepsis Campaign.
What are you’re views about administration of IV fluids in patients that are clearly septic, but who’s blood pressure is still normotensive. This is of particular concern in the previous hospital environment, where cryptic shock may be present in the normotensive patient, but the lactate is rising as a result of SIRS exerting it’s effect on the body, JRCALC only states to administer fluids when the blood pressure is below 90mmhg, however my concern is that we are missing the point in waiting for the BP to drop before administering iv fluids. Is it harmful to administer 1 to 2 litres of saline to this cohort of patients.
I would guess that a significant portion of that cohort might be harmed by a 1-2 liter saline bolus. Perhaps a generous maintenance rate could be started…that way if the patient’s blood pressure drops everything is connected and the fluid can be quickly switched to “wide open”. Are you able to check serial lactates in the pre-hospital setting? I know there is a non-FDA approved point of care testing device…